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Meta Analysis Evaluating Efficacy of 0.01% Atropine for Myopic Progression in ChildrenAtropine Eye Drops May Slow Myopia Progression in Children

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Key Takeaway
0.01% atropine significantly slows myopia progression, with notably higher efficacy observed in South Asian children.

This meta-analysis evaluated the efficacy of 0.01% atropine eye drops compared to placebo in children with myopia. The study analyzed data from 4,374 children across various ethnicities to determine the impact on spherical equivalent refraction (SER) and ocular axial length (AL).

Overall results indicated a 37% reduction in SER progression for the general population. When stratified by ethnicity, the data revealed significant variations: South Asian children experienced a 66% reduction, while East Asian and white children showed reductions of 35% and 28%, respectively. These findings suggest that treatment efficacy may vary based on genetic backgrounds.

Clinicians should note that the mean difference in SER progression compared to placebo was 0.21D per year. While the study confirms the general effectiveness of low-concentration atropine, the significant disparity in outcomes across ethnic groups suggests that personalized treatment approaches may be necessary to optimize clinical outcomes for diverse patient populations.

How this fits prior evidence

This meta-analysis extends the existing evidence that 0.01% atropine reduces axial length by 0.04 mm/year in children with myopia. While the previous finding established a modest axial length reduction, this new meta-analysis provides more granular data on spherical equivalent refraction (SER) progression across different ethnicities, specifically showing a 37% overall reduction in SER progression.

A large meta-analysis looked at the effects of 0.01% atropine eye drops on myopia, which is a common condition where children have trouble seeing distant objects. The study included data from 4,374 children of various ethnicities to see how well the drops slowed the growth of the eye and the change in vision.

The results showed that the eye drops slowed the progression of nearsightedness overall by 37% compared to a placebo. The study also found that the effectiveness of the drops varied by ethnicity. Specifically, the reduction in progression was 66% for South Asian children, 35% for East Asian children, and 28% for white children.

While the study shows a clear link between atropine and slower vision changes, it is important to note that results vary based on the child's background. Because this is a meta-analysis of several trials, it provides a broad overview of the data. You should talk to an eye doctor to see if this treatment is right for your child's specific needs.

What this means for you:
Atropine eye drops may slow myopia progression in children, with varying levels of effectiveness by ethnicity.

Common questions

How effective are atropine eye drops for children with myopia?

The study found that 0.01% atropine eye drops resulted in a 37% overall reduction in the progression of nearsightedness compared to a placebo. This means the drops helped slow down the changes in eye shape and vision for the children included in the study.

Does the effectiveness of atropine change based on ethnicity?

Yes, the study showed different levels of success based on ethnicity. The reduction in progression was 66% for South Asian children, 35% for East Asian children, and 28% for white children. Doctors may use this information to help decide the best treatment plan.

What specific measurements were used to track progress?

Researchers measured the change in spherical equivalent refraction (SER) and the growth of the eye, known as ocular axial length (AL). The study found that the atropine group had a mean difference of 0.21D per year in SER progression compared to those using a placebo.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
BACKGROUND/AIMS: Although 0.01% atropine is widely used for myopia control, its efficacy is debated and its effectiveness across different ethnicities is unknown. We aim to evaluate its efficacy in different ethnic backgrounds. METHODS: The randomised clinical trials (RCTs) that compared 0.01% atropine against a placebo in myopic children from five databases through August 2025 were included. The primary outcomes included (1) the ratio of the means (RoM), defined as the RoM of annual changes in spherical equivalent refraction (SER) or ocular axial length (AL) in 0.01% atropine to the placebo groups, for accounting in the natural progression; and (2) the mean differences (MDs) in SER progression and AL elongation. RESULTS: A meta-analysis of 25 RCTs (4374 children aged 4-18) showed that 0.01% atropine reduced the SER progression by 37% annually (RoM: 0.63; 95% CI 0.54 to 0.74), with efficacy being much greater in South Asian populations (66% reduction; RoM: 0.34, 95% CI 0.27 to 0.42), than East Asian populations (35% reduction; RoM: 0.65, 95% CI 0.54 to 0.78) and white populations (28% reduction; RoM: 0.72, 95% CI 0.59 to 0.86) (p<0.0001). Regarding the MD, 0.01% atropine was effective in slowing an overall myopia progression of 0.21D per year (95% CI 0.15D to 0.27D) compared with placebo group. A similar pattern was observed in AL elongation. CONCLUSION: 0.01% atropine effectively slows myopia progression across ethnicities, with the greatest efficacy observed in South Asian populations. Clinical practice should consider this ethnic difference to optimise the treatment effects. PROSPERO REGISTRATION NUMBER: CRD42025632545.
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